Essential Prescriptions of the Golden Coffer is the long-awaited companion to Paradigm Publication's acclaimed Shan Han Lun. We plan for it to be available in the summer of 2009.
The following sample shows the current state of the text and its progress; the content may change as the work progresses.
Bowels & Viscera, Channels & Network Vessels Disease
Sequence, Pulses & Signs
This first chapter describes the causes and pathomechanisms of disease of the bowels and viscera and of the channels and network vessels, the sequence in which their occur, and the pulses and signs by which they are recognized. It forms a general introduction to the Jin Gui as a whole. Short as it is, it covers a broad range of subjects including prevention of disease, causes of disease, pathomechanisms, diagnostics, principles of treatment, nursing, and prognosis and provides copious examples.
The contents are broad-ranging, but throughout the emphasis is on the holistic view of health and disease, stressing not only the relationship between the human body and outside world, but the unity within the body. The interdependence and counterbalancing between the bowels and viscera, and between the channels and network vessels explain the ways in which they interact in disease. Disease in one bowel or viscus can transfer to another bowel or viscus. Disease in one channel can transfer to another. Evils contracted through the channels and network vessels can pass into the bowels and viscera. Disease of the bowels and viscera can manifest at positions on the pathways of the channels and network vessels.
(1) Wen4 yue1: Shang4 gong1 zhi4 wei4 bing4, he2 ye3? Shi1 yue1: Fu1 zhi4 wei4 bing4 zhe3, jian4 gan1 zhi1 bing4, zhi1 gan1 chuan2 pi2, dang1 xian1 shi2 pi2, si4 ji4 pi2 wang4 bu4 shou4 xie2, ji2 wu4 bu3 zhi1. Zhong1 gong1 bu4 xiao3 xiang1 chuan2, jian4 gan1 zhi1 bing4, bu4 jie3 shi2 pi2, wei2 zhi4 gan1 ye3.
(2) Fu1 gan1 zhi1 bing4, bu3 yong4 suan1, zhu4 yong4 jiao1 ku3, yi4 yong4 gan1 wei4 zhi1 yao4 tiao2 zhi1. Suan1 ru4 gan1, jiao1 ku3 ru4 xin1, gan1 ru4 pi2. Pi2 neng2 shang1 shen4, shen4 qi4 wei1 ruo4, ze2 shui3 bu4 xing2; shui3 bu4 xing2, ze2 xin1 huo3 qi4 sheng4; xin1 huo3 qi4 sheng4 ze2 shang1 fei4; fei4 bei4 shang1, ze2 jin1 qi4 bu4 xing2; jin1 qi4 bu4 xing2, ze2 gan1 qi4 sheng4. Gu4 shi2 pi2, ze2 gan1 zi4 yu2. Ci3 zhi4 gan1 bu3 pi2 zhi1 yao4 miao4 ye3. Gan1 xu1 ze2 yong4 ci3 fa3, shi2 ze2 bu4 zai4 yong4 zhi1.
(3) Jing1 yue1: xu1 xu1 shi2 shi2, bu3 bu4 zu2, sun3 you3 yu2. Shi4 qi2 yi4 ye3. Yu2 zang4 zhun3 ci3.
(1) Question: The superior practitioner "treats disease before it arises" What does this mean? The Master says: "Treating disease before it arises means [for example that if one] sees disease of the liver, one knows that it will pass from the liver to the spleen, [so that one] must first firm the spleen [and only if] the spleen is effulgent [throughout] the four seasons is it not necessary to supplement it. The practitioner of medium proficiency does not know about the passage of disease [from one part to another, so that when he] sees liver disease, he does not understand the need to firm the spleen, and treats only the liver."
(2) In liver disease, one supplements using sourness, assists using burntness and bitterness, and boosts using medicinals of sweet flavor to harmonize. Sourness enters the liver, burntness and bitterness enter the heart, and sweetness enters the spleen. The spleen can damage the kidney,\n when kidney qi4 is weak, water fails to move; when water fails to move, heart fire becomes exuberant; when heart fire becomes exuberant, it damages the lung; when the lung is damaged, the metal qi4 fails to move; and when metal qi4 fails to move, liver qi4 becomes exuberant. Therefore when one firms the spleen, the liver recovers on its own. This is the main subtlety of treating the liver by supplementing the spleen. This method is used for liver vacuity; it is not used for repletion.
(3) The Canon says, "[Because of the danger of] evacuating vacuity and replenishing repletion,\n [one should] supplement insufficiency and reduce superabundance." This is what is meant here. The other viscera follow this [scheme too].
1. Superior practitioner 上工 shang4 gong1: In ancient China, a superior practitioner was one with a nine-out-of-ten success rate, a mediocre practitioner (中工 zhong1 gong1) was one with a seven-out-of-ten success rate, and an inferior practitioner (下工 xia4 gong1) was one with a six-out-of-ten success rate.
2. Treat disease before it arises 治未病 zhi4 wei4 bing4: To prevent disease from arising. Here, it clearly means treat bowels and viscera not yet affected by disease, in order to prevent the transmission and mutation of disease. The term therefore also means to prevent to advance of disease.
3. The Master 师 shi1: This is presumed to mean Zhang1 Ji1. If this is so, then it may well be that the text, at least in part, was written down by students rather than by Zhang1 himself. A student's question followed by the Master's answer is a format in which a considerable number of lines are set.
4. Firm the spleen 实脾 shi2 pi2: Supplement the spleen.
5. Spleen is effulgent [throughout] the four seasons 四季脾旺 si4 ji4 pi2 wang4: The spleen belongs to heart, and earth is effulgent through the four seasons. Here the meaning is that spleen qi4 is exuberant for the whole of each year.
6. The spleen can damage the kidney 皮能伤肾 pi2 neng2 shang1 shen4: The spleen can restrain the kidney.
7. The Canon 经 jing1: It is not known what book this refers to.
8. Evacuate vacuity and replenish repletion 虚虚实实 xu1 xu1 shi2 shi2: To exacerbate vacuity by draining and exacerbate repletion by supplementation.
This line describes the notion of treating disease before it arises. Through the example of liver disease giving rise to spleen disease, we can see that treating disease before it arises means preventing particular conditions arising during the course of disease.
This line opens with the notion, central to Chinese medicine, of treating disease before it arises, which means nipping any pathological condition in the bud and preventing a condition from spreading or developing further. Physicians can only do this when the fully understand the relationships between each of the internal organs and how diseases develop and spread from one locus to another.
When, for example, there is liver repletion, the spleen is threatened. According to five phase theory, wood restrains earth. When wood becomes too strong, it overwhelms earth. Hence, earth has to be strengthened to prevent this. So in liver repletion, if the spleen weak, it has be regulated and supplemented to protect it from being damaged by the liver. This is to treat spleen disease before it arises. The overwhelming cycle only applies in repletion, not in vacuity. In liver vacuity, there is no threat to the spleen.
Vacuity and repletion have to be carefully distinguished. Again this point also explained through the example of the liver. Sourness is the flavor that enters the liver. In liver vacuity, sourness is appropriate. Burntness and bitterness are the flavors associated with the heart. Because wood engenders fire, the heart is the child of the liver. Supplementing the child can strengthen the mother, so burntness and bitterness can be used to complement sourness. This approach is appropriate for liver vacuity, but not for liver repletion.
The section from ``Sourness enters the liver'' to ``This is the main subtlety of treating the liver by supplementing the spleen'' explains in detail the reasons for using sour, sweet, charred and bitter flavors to treat liver vacuity. In terms of the five phases, liver-wood normally restrains lung-metal. When the liver becomes vacuous, the normal relationship is upset, and lung-metal is bound to rebell against it. So before the lung-metal rebels against liver-wood, it is appropriate to sourness to supplement the liver itself and use burnt-bitter flavor to assist heart-fire. There are three reasons for assisting heart fire: When heart-fire is effulgent, (1) 感气于肝, (2) 可以不泄肝气, (3) it can restrain the liver, preventing if from restraining the liver and allowing the liver to recover. Sweetness is used because it enters the spleen. Supplementing the spleen enhances the ability of spleen-earth to restrain kidney-water (supplementing earth to dam water). This is what is meant by ``the spleen can damage the kidney.'' When the yīn-cold water-qì of the kidney kept in check, this prevents ``water qì damaging the heart.'' When the lesser fire of the heart is exuberant, it can restrain lung metal, which in turn helps to prevent lung-metal from rebelling against liver-wood. Moreover, it is said that ``earth can luxuriate wood'' (土能荣木 tu3 neng2 rong2 mu4): When spleen qì is exuberant, it can help to supplement the vacuity of the liver.
Finally, the last section is quite clear. Vacuity is normally treated by supplementation and repletion by drainage. If drainage is used to treat vacuity, or supplementation is used to treat repletion, this to commit the error ``evacuating vacuity'' or ``replenishing repletion.'' In either case, the patient is harmed.